The Effect of a Community-Based Self-Help Intervention

Abstract

Introduction Korean Americans are one of the most underserved ethnic/linguistic minority groups owing to cultural and institutional barriers; there is an urgent need for culturally competent diabetes management programs in the Korean American community for those with type 2 diabetes. The purpose of this study was to test the effectiveness of a community-based, culturally tailored, multimodal behavioral intervention program in an ethnic/linguistic minority group with type 2 diabetes. Design A RCT with waitlist comparison based on the Predisposing, Reinforcing, and Enabling Constructs in Education/environmental Diagnosis and Evaluation (PRECEDE)–Policy, Regulatory, and Organizational Constructs in Educational and Environmental Development (PROCEED) and self-help models. Data were collected between September 2010 and June 2013 and were analyzed in August–December 2014. Statistical significance was set at p<0.05. Setting/participants In a naturally occurring community setting, a total of 250 Korean Americans with type 2 diabetes were randomized into an intervention group (n=120) or a control group (n=130). Intervention The intervention consisted of key self-management skill-building activities through 12 hours of group education sessions, followed by integrated counseling and behavioral coaching by a team of RNs and community health workers. Main outcome measures Primary (clinical) outcomes were hemoglobin A1c, glucose, total cholesterol, and low-density lipoprotein at baseline and 3, 6, 9, and 12 months. Secondary (psychosocial and behavioral) outcomes included diabetes-related quality of life, self-efficacy, adherence to diabetes management regimen, and health literacy. Results During the 12-month project, the intervention group demonstrated 1.0%–1.3% (10.9–14.2 mmol/mol) reductions in hemoglobin A1c, whereas the control group achieved reductions of 0.5%–0.7% (5.5–7.7 mmol/mol). The differences between the two groups were statistically significant. The intervention group showed statistically significant improvement in diabetes-related self-efficacy and quality of life when compared with the control group. Conclusions RN/community health worker teams equipped with culturally tailored training can be effective in helping an ethnic/linguistic minority group manage diabetes in the community.

Health information needs assessment among self-help groups and willingness for involvement in health promotion in a rural setting in Puducherry: A mixed-method study

“…This adds to the list of various other activities where their involvement is found to be effective. [2526] We also noted that the results obtained through both qualitative and quantitative parts were comparable, thereby enabling triangulation of the data. This model will be even more effective if these vibrant members are given adequate training not only regarding their perceived needs but also regarding their experiment incorporating training programs on leadership and advocacy, thereby stressing upon how leadership qualities can pave to organizational success.…”

Efficacy of Diabetes Education in Adults With Diabetes Mellitus Type 2 in Primary Care: A Systematic Review

“…Mixed educational programs combine individual and group education through strategies such as home visiting, telephone intervention, or group education (Jutterström, Hörnsten, Sandström, Stenlund, & Isaksson, 2016;Kim et al, 2015;Spencer et al, 2011;Torres, Pace, Chaves, Velasquez-Melendez, & Reis, 2018).…”

“…In contrast, the study with the worst results was by Grillo et al (2016), which was based on a group education program of 5 weeks' duration with reinforcement every 4 months over a year. LDL-C decreases ranged from 7 mg/dL (p < .005; Kim et al, 2015) to 18.3 mg/dL (p = .000; Parra et al, 2015). The study by Parra et al (2015), as with SBP and total cholesterol, was the one that obtained the best results.…”

Factors Predicting Sodium Intake of Korean Americans with Type 2 Diabetes

“…One additional inclusion criteria was added for the present study—participants must have completed all instruments used in the current study analysis at the baseline data collection time. Exclusion criteria were that participants: (1) had a physical or mental health condition that limited active participation in the study (e.g., bilateral blindness, severe immobility, psychiatric disease); or (2) had a hematological condition that could affect A1C assay (e.g., hemolytic anemia, sickle cell anemia) [23]. A total of 232 participants out of 250 KAs in the original study met the eligibility criteria and were included in this analysis.…”